Overactive letdown is when your breast milk comes out too fast and hard at letdown. Learn how to spot it—and how to handle this frustrating issue.
I’ll never forget nursing Paloma in those first few weeks of life. As an “experienced” nurser, I thought it was going to be smooth and easy. Instead, I found her choking, coughing, and pulling off the breast more times than I could count. I was sore. She was hungry. And we were both unhappy. After meeting with a lactation consultant, I learned that I had a condition called overactive letdown.
What is an Overactive Letdown?
An overactive letdown is when your breast milk comes out too fast and hard at letdown.
Is overactive letdown the same thing as oversupply?
Sometimes an overactive letdown can come hand-in-hand with having an oversupply of milk. Many moms have this in the first 4-6 weeks postpartum, as this is by design to ensure there is enough food for baby. Usually, your baby will help to regulate your supply and the issue resolves itself.
Signs of Overactive Letdown
With a newborn baby who is still getting the hang of sucking, swallowing, and assimilating his food, an overactive letdown can be frustrating to say the least.
Some signs to look out for:
- Baby choking during feeding
- Baby coughing during or after feeding
- Pulling back at breast or tugging at the breast or nipple
- Squealing, squeaking, or gulping excessively while nursing
- Make clicking sound at breast (this can also be a sign of tongue or lip tie)
- Milk dribbling down side of baby’s mouth
- Crying or resisting the breast
- Excessive gas, hiccuping or spitting up
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Does a Forceful Letdown Cause Problems?
Many moms with overactive letdown have gassy or even colicky babies, because baby is consuming too much foremilk and not enough hindmilk.
- Foremilk is the thin, watery, and lactose-rich component of breast milk that is great for hydration and quick energy.
- Hindmilk is the creamy and fat-rich part of breast milk that provides nourishment, satiety, and contentment.
Babies who receive too much foremilk suffer with excess gas (farting, belching, hiccups, etc.), hunger, and even colic, because foremilk can digest too quickly, resulting in malabsorption and intestinal distress. Because of this, baby generally has to feed more frequently, leading to sore breasts.
Luckily, most babies learn to adapt to their mom’s letdown as they grow and their digestive system matures.
Tips to Handle Overactive Letdown
1. Clamp down
“Clamping down” on the areola can help slow down the milk flow and allow baby to drink at a more agreeable pace (or even suckle for comfort). How do you do it? Remember the game “Rock, Paper, Scissors”? Use the scissors hand pose and squeeze down hard on your areola. This will slow the flow coming out of your milk ducts. Beware that you might develop finger/hand soreness or cramping, so take breaks now and then.
2. Try laid-back nursing
Sometimes called “Biological Nurturing,” this is a great breastfeeding position for those with an overactive letdown. Let the baby rest on you, so you’re facing belly to belly. You can even let the baby root for the breast herself and latch on. Nursing this way works against gravity, therefore slowing the flow of milk into baby’s mouth. It’s also pretty comfortable! Another option is side-lying position, as sometimes excess milk can dribble out of breast and/or side of baby’s mouth easily this way.
3. Pull baby off at letdown
Many babies struggle the most during the actual milk letdown, which usually takes place 30 seconds to a few minutes into nursing. Most moms can feel their milk preparing to come down their milk ducts—many describe this feeling as a tingle. A great way to ease baby’s discomfort with an overactive letdown is take him off the breast and catch the forceful milk in a towel, burp cloth, or breast milk bag. Once letdown is complete, re-latch baby and let him nurse. If you want to save the milk from the other breast that’s released during letdown (each drop is so valuable!), check out this product. If you are tandem nursing, you can have your toddler drink for the first minute or two during letdown, then pop baby back onto your breast.
4. Use a pacifier (very judiciously)
Wha wha what?! Mama Natural is recommending a pacifier? For moms with an overactive letdown, it can be a wonderful tool. Babies are born with a strong reflux to suck. In some feeding situations, babies get to suckle both breasts for about 30 minutes total per feeding. When you have an overactive letdown, feeding sessions may only last about five minutes. If your baby is content, no worries. But during the witching hour when baby wants to suckle for comfort but is overwhelmed by the milk flow, you could try a pacifier. (This is a good one for newborns.) You can also try using a very clean finger for baby to suck on as an alternative.
5. Try block feedings
If you’re dealing with oversupply issues, offer just one breast per feeding. Moms with severe oversupply issues can even offer that same breast for the next feeding and then offer the second breast. This way you can be sure baby will get all of the good hind milk and make for a more pleasant nursing experience, since the milk letdown won’t be as rapid as the breast empties. This will also help regulate overall milk production, since you’re not stimulating both breasts at each feeding. Be sure to work with a lactation consultant to decide if block feeding is right for you.
6. Do gua sha
Studies show, when coupled with proper breastfeeding techniques, gua sha, an ancient form of massage seeing a resurgence, is more effective at reducing engorgement and discomfort in the immediate postpartum period than massage and hot packs.
7. Get help
There are so many great resources out there if you continue to struggle with feedings. Check in with a lactation consultant —they are worth their weight in gold and can provide hands-on help with overactive letdown issues or, even more importantly, diagnose any issues that may be preventing your child from latching and drinking your milk well—like a tongue tie or lip tie. Here’s how to find a local lactation consultant.
Additionally, consider attending a local La Leche or Breastfeeding USA meeting (they’re free!). These organizations are led by nursing mamas or even breastfeeding counselors and are filled with other nursing moms just like you. You’ll find other mamas who have dealt with the same issues and can share their experience with you.
It Gets Better!
Bottom line, don’t give up. Breastfeeding does get easier for baby and for mama. As your baby grows, she’ll be able to drink up and enjoy your overactive letdown (it’s true!). In the interim though, try the above-mentioned tips to get you through those uncomfortable first weeks or months as you both adjust.
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How About You?
Have you tried anything that works with reducing milk supply or slowed a fast letdown? Share with us so we can learn from each other!